ANTI

HYPOTENSIVE
MEDICATIONS
 HYPOTENSION
✔ Vital centers in the brain and the rest of
the tissues of the body may not receive
sufficient oxygenated blood to continue
functioning.
✔ It puts the body in serious jeopardy; it is
often an acute emergency situation, with
treatment required to save the patient’s
life.
 1.) VASOPRESSORS/
SYMPHATOMIMETICS
✔Otherwise known as “Symphatetic Adrenergic
Agonist”.
✔ React with sympathetic adrenergic
receptors to cause the effects of a
sympathetic stress response: increased
blood pressure, increased blood volume,
and increased strength of cardiac
muscle contraction.
✔ These actions increase BP and may
restore balance to the
cardiovascular system while the
underlying cause of the shock (e.g.,
volume depletion, blood loss) is
treated.
✔ First choice for treating severe
hypotension or shock.
 REPRESENTATIVE AGENTS
✔ Dobutamine (Dobutrex)
✔ Dopamine (Intropin)
✔ Ephedrine (generic)
✔ Epinephrine (Adrenalin, EpiPen)
✔ Isoproterenol (Isuprel)
✔ Norepinephrine (Levophed)
✔ Phenylephrine (Neo-Synephrine)
 ADVERSE EFFECTS
✔ Decreased GI activity with nausea and
constipation, increased respiratory rate and
changes in BP, headache, and changes in
peripheral blood flow with numbness,
tingling, and even gangrene in extreme
cases.
✔ It should be used with caution with any
disease that limits blood flow, with
tachycardia, or with hypertension.
 2.) ALPHA SPECIFIC ADRENERGIC
AGENTS
✔ Midodrine (ProAmatine) is used to
treat orthostatic
hypotension—hypotension that occurs
with position change—that interferes
with a person’s ability to function and
has not responded to any other
therapy.
 THERAPEUTIC ACTIONS
✔ It activates alpha-receptors in
arteries and veins to produce an
increase in vascular tone and an
increase in blood pressure.
✔ It is indicated for the symptomatic
treatment of orthostatic
hypotension.
 PHARMACOKINETICS
✔ Rapidly absorbed from the GI tract,
reaching peak levels within 1 to 2 hours.
✔ It is metabolized in the liver and
excreted in the urine with a half-life of 3
to 4 hours.
✔ Caution should be used during
lactation.
 CONTRAINDICATIONS
✔Contraindicated in the presence of supine
hypertension, CAD, or pheochromocytoma
because of the risk of precipitating a
hypertensive emergency.
✔ Acute renal disease, urination retention,
pregnancy, and lactation.
✔ With visual problems
 ADVERSE EFFECTS
✔ Piloerection, chills, and rash
✔ Hypertension and bradycardia
✔ Dizziness, vision changes, vertigo
✔ Headache; and problems with urination.
 DRUG- DRUG INTERACTIONS
✔ There is a risk of increased effects and
toxicity of cardiac glycosides,
beta-blockers, alpha-adrenergic agents,
and corticosteroids if they are taken with
midodrine.
✔ Dose adjustment is necessary.